Scotland must improve access to housing adaptations and deliver national oversight to ensure local authorities are fulfilling their duty to support people to live well at home and stay out of hospital, say the authors of a report.

The ‘What’s Next for Adaptations?’ report looked at demand across Scotland for home adaptations – from stairlifts and grabrails to dementia-friendly designs, signage and lighting.

It reveals that a failure of policy around adaptations is putting significant strain on the NHS.

Led by the University of Stirling’s Intersectional Stigma of Place-Based Ageing group (ISPA), the report calls for the Scottish government to increase funding for adaptations and improve accountability.

It found that older and disabled people who were unable to access required adaptations were more prone to falls and injuries in their homes.

With thousands of Scots living in homes that do not meet their needs, the researchers urge Scotland’s leaders to recognise the ‘devastating impact’ of unsuitable accommodation.

One occupational therapist involved in the research said:

“For every £1 spent on equipment adaptations, [there] is a £6 saving across health and social care so it just has always seemed absolute lunacy to me that, instead of actually investing in something that’s going to save you £6 across health and social care for every £1 you spend, we continue to actually cut budgets [and] kick the can down the road.

“It’s not the solution to the budget pressures. It’s one of the causes of the budget pressures.”

The report’s authors emphasise that the solutions are well-understood, calling for the government to strengthen Scotland’s legislation and deliver clear, enforceable standards on housing adaptations.

A commitment to embedding early intervention and inclusive design across Scotland’s homes is also needed.

The researchers also say embracing technology could improve people’s quality-of-life and the time they can stay at home, avoiding unnecessary hospital or care home admissions.

The report says the government must also deliver sustained and sufficient funding for housing adaptations and the staffing necessary to coordinate, deliver and assessments.

In the report’s foreword, Kay Allen OBE, Director of social enterprise Age Irrelevance said now is the time for collective action to move towards more inclusive housing across Scotland:

“This report calls for the government to prioritise accessible and adaptable homes, viewing them not as a budget for reduction but as vital investments in our future.

“I add my call for action. We have decades of research and recommendations. Indeed, it is 30 years since the Disability Discrimination Act.”

Despite local authorities in Scotland having a statutory duty to support housing adaptations, the delivering and monitoring of this aspect of their work is ‘fragmented’.

Report authors say Scotland lacks a single accountable body to oversee the adaptations process and collect relevant data, meaning access not only differs depending on where applicants live, but also whether they own their home, rent privately, or from a social landlord.

Project lead, the University of Stirling’s Professor Vikki McCall said national investment in housing adaptations now could prevent costly year-on-year spend later:

“While our population is living longer, that doesn’t mean we are living well.

“All our research points to the need for futureproofing of Scotland’s housing stock, early intervention, and age-friendly, inclusive designs.”

Joining the call for action alongside the University of Stirling are the Scottish Federation of Housing Associations (SFHA), the Chartered Institute of Housing Scotland (CIH Scotland) and the Association of Local Authority Chief Housing Officers (ALACHO).

Ashley Campbell, Policy and Practice Manager at CIH Scotland said this new research adds to “significant and growing” work on improving housing in Scotland:

"The message is clear – we know that investing in adaptations saves money for health and social care partners and improves people’s lives.

“But this isn’t just about the funding. The system can be complex, time consuming and inconsistent.

“We need the Scottish government to fulfil its commitment to review the adaptations system and remove barriers to accessing support.”

The report authors highlight that the overcomplicated and underfunded system undermines the promise of healthy ageing, independent living, and dignity for all.

This comes as Scotland’s healthy life expectancy hit a ten-year low, whilst the population of those aged over 60 is set to exceed 1.7 million by 2035.

SFHA Chief Executive Sally Thomas said:

“This crucial research shines a light on the complex and unfair process people go through every day just to access vital adaptations which help them live well and for longer in their home.

“The current adaptations system is unfit for our ageing population and places too much emphasis on whether someone rents or owns their home, where they live, and what funding they can access instead of people’s needs.”

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